16. Thorax I - Genral and Lungs

Question 1

What are Cooper ligaments?

Answer 1

Cooper ligaments are suspensory ligaments, which attach the mammary gland to the skin and run from the skin to the deep fascia.

Question 2

What causes the dimpling of the skin in the presence of a tumor?

Answer 2

The tumor distort the Cooper ligaments.

Question 3

Most of the arterial blood supply to the breast comes from where?

Answer 3

From the internal thoracic (internal mammary) artery. However, the lateral thoracic and thoracoacromial branches of the axilary artery and the intercostal arteries also contribute to the blood supply.

Question 4

Which is the venous drainages of the breasts?

Answer 4

Primarily to tributaries of the axillary vein.

Question 5

Where does most of the lymph in the breast drains to?

Answer 5

To axillary nodes (pectoral group).

Question 6

What sensory fibers innervate the breast?

Answer 6

Intercostal nerves 2-6. These nerves also carry sympathetic fibers, which supply the smooth muscle of the areolae.

Question 7

What structures does the manubrium articulate with?

Answer 7

The clavicle and the first rib.

Question 8

Around what age does the xiphoid process ossify and unites with the body of the sternum?

Answer 8

Around age 40.

Question 9

Which are the True ribs?

Answer 9

Ribs 1-7 are termed “true ribs” and attach directly to the sternum by costal cartilage.

Question 10

Which are the false ribs?

Answer 10

Ribs 8-10 are termed “false ribs” and attach to the costal cartilage of the rib above.

Question 11

Which are the floating ribs?

Answer 11

Ribs 11-12 have no anerior attachments, and are therefore classified as both “floating ribs” and false ribs.

Question 12

Where is the costal groove and what does it do?

Answer 12

It is located along the inferior border of each rib and provides protection for the intercosal nerve, artery and vein.

Question 13

What does the coartation of the aorta leads to?

Answer 13

It increases blood flow thru the intercostal arteries. Enlargement of these arteries results in costal notching on the lower border of the ribs.

Question 14

Which section of the intercostal space is utilized in the passage of an instrument and why?

Answer 14

It is done in the lower portion of the space to avoid the intercostal neurovascular structure.

Question 15

Which portion of the intercostal space is utilized for an intercostal nerve block?

Answer 15

The upper portion of the intercostal space.

Question 16

Where are pairs 1-6 anterior intercostal arteries derived from?

Answer 16

From the internal thoracic arteries.

Question 17

Where are pairs 7-9 anterior intercostal arteries derived from?

Answer 17

From the musculophrenic arteries.

Question 18

Where are pairs 1-2 posterior intercostal arteries derived from?

Answer 18

From the superior intercostal arteries, a branch of the costocervical trunk of the subclavian artery.

Question 19

Where are pairs 3-11 posterior intercostal and subcostal arteries derived from?

Answer 19

From the thoracic aorta.

Question 20

Where do the Anterior branch of the intercostal vein drain to?

Answer 20

To the internal thoracic and musculophrenic veins.

Question 21

Where do the Posterior branch of the intercostal vein drain to?

Answer 21

To the azygos system of veins.

Question 22

Where does the anterior lymphatic of intercostal spaces drain to?

Answer 22

Thoracic (parasternal) nodes.

Question 23

Where does the posterior lymphatic of intercostal spaces drain to?

Answer 23

Para-aortic nodes of the posterior mediastinum.

Question 24

Where does the respiratory (laryngotracheal) diverticulum form?

Answer 24

In the ventral wall of the foregut.

Question 25

What does the tracheoesophageal septum divide?

Answer 25

The foregut into the esophagus and trachea.

Question 26

What does the distal end of the respiratory diverticulum enlarges to?

Answer 26

To form the lung bud.

Question 27

What does the lung bud evolve to?

Answer 27

It divides into two bronchial buds, which branch into the main bronchi, lobar bronchi, and segmental bronchi.

Question 28

What is the tertiary bronchi related to?

Answer 28

To the bronchopulmonary segements of the the lungs.

Question 29

How many stages of lung development are there?

Answer 29

4

Question 30

What is a tracheoesophagela fistula?

Answer 30

It is an abnormal communication between the trachea and esophagus caused by a malformation of the tracheoesophageal septum. The fistula is most commonly (90%) located between the esophagus and distal third of the trachea.